Vaginally-Born Babies Can Have Respiratory Issues Too: My Own Experience

I am not a medical professional. Please research your options and discuss them with your care provider when making health decisions. This post may contain affiliate links. This means that if you make a purchase, I may make a small commission at no additional cost to you. Thank you for supporting this free resource! See full disclosure here.

So in my recent post about the benefits of vaginal birth I shared a lot of studies that show increased rates of asthma, allergies, type 1 diabetes, celiac disease and others among children who were born by cesarean. Whenever I share about negatives associated with a certain practice or outcome I’m afraid of making parents who have experienced those outcomes feel criticized or judged or guilty or just bad in any way.

Cesarean birth does increase those risks, but it is just one of many factors. There are so many decisions you make as a parent that are important to your kids. And let’s be honest, physical health matters, but there are lots of things that matter more to our kids, like feeling safe, knowing they’re precious to you, nurturing their souls. And there are all kinds of outcomes we can’t control. Nothing we do can guarantee a perfectly healthy kid.

When I was preparing for the birth of my firstborn avoiding a c-section was a pretty high priority to me. I knew the cesarean rate was high in the US and wanted to decrease my risk as much as possible. I switched care providers around 30 weeks because of the red flags I was seeing in my initial care, and I had a pretty textbook vaginal delivery.

And my son still has a weak respiratory system. So I just want to share my own experience in hopes that parents won’t feel like they’ve somehow failed their child if the child was born by cesarean. And to remind them that there are sometimes circumstances that are simply outside our control, but that there are a thousand good ways to be a parent that are within their control.

My Own Experience with Having a Child with Respiratory Issues

My two sons were both born vaginally. They were born at home, so they weren’t exposed to some of the concerning bacteria more common in a hospital setting.

But my oldest is definitely prone to respiratory issues. It seems like every time there is a respiratory bug going around he gets it and gets it bad. Though he’s never been officially diagnosed with asthma, as a baby he had wheezing , and we gave him albuterol through a nebulizer (though we chose to forego the steroids). I’m pretty cautious with medication for my kids, but it was definitely scary enough for me to give it to him without a second thought. Though he’s not as sensitive as he used to be, he easily develops asthma symptoms whenever he has more than a miniscule amount of dairy.

So he has the birth factors for a lower risk of respiratory issues, yet he still has them. I have my own theories as to why he does have them and why my second child doesn’t (at least not yet).

What My Kids Have in Common

1. With both babies, my water didn’t break until pretty shortly before they were born, so they had less time to be “soaking” in vaginal flora. Was this within my control? Technically, yes, I guess I could have asked to have my midwife break my water sooner, but not much sooner, because I’ve had pretty quick births. And there are risks to artificial rupture of membranes that, for me, aren’t worth the possible benefit of my baby being exposed to vaginal flora for a slightly longer period of time.

2. I don’t know that my own microbiome was all that healthy to pass on to them. Mothers pass their microbiome almost directly to their babies, and my own mother was not breastfed, so when I was born, her own microbiome was probably not in optimal health. And I wasn’t very consistent about taking probiotics or anything. I don’t know if this has anything to do with it; it’s just something I wonder about. Do I have control over the microbiome that was passed on to me? Nope. Could I have improved my own microbiome more? Probably. But I’m not beating myself up about it.

3. My husband has asthma and allergies, so I wonder if there’s a genetic component. Do I have control over his genetics? Nope.

So these are all factors that both my babies have in common – same birth setting, similar birth events, and same dad. But my second baby is now 11 months old, and so far he hasn’t had the respiratory issues that my firstborn has (which started around 9-10 months).

What We Did Differently with Baby #2

Of course there were some differences between my first and second. They obviously have a difference set of genetics, though with some in common. My first was born in late fall, my second in early summer. We skipped the Vitamin K shot with my second. We already knew we weren’t going to circumcise, so we didn’t get it. Honestly, I didn’t give it much thought at the time, and future babies might get the shot, or we may do the oral vitamin K drops. I just haven’t researched it enough to be sure I’m comfortable either way. Here‘s a great article from Evidence Based Birth on the research behind the vitamin K shot.

I’m not sure what if any effect any of those differences have had on my second born’s respiratory health, and some of them aren’t within my control. But there is one thing we purposefully and conscientiously did differently.

We introduced food differently.

With my firstborn, I did a modified baby-led weaning approach.   He had a few tastes of food around 5 months, and I started giving him a small amount of food every day starting at 6 months. He got his first tooth at 7 months, and by 8 or 9 months, I was pretty laid-back about what he ate. He didn’t eat junk food or anything, but as long as it was real, unprocessed food, I wasn’t too worried about it. So he definitely had dairy and eggs and nuts and some of those other harder-to-digest foods well before a year old. And we eventually discovered he had a dairy intolerance that significantly worsened his respiratory issues, especially the asthmatic wheezing.

With my second, I was really hoping to avoid food allergies and intolerances, so I took a different approach. We still did a sort of modified baby-led weaning approach (by modified, I mean we mostly let our babies pick up food and feed themselves, experiencing a greater variety in textures, but when it was convenient we mashed up food and spoon-fed them).

But this time we introduced foods more slowly, starting with foods that were the most easily digestible, and then moving on to harder-to-digest foods, per the recommendation of our naturopath. He also had a few tastes of food around 5 months and started eating food more consistently at 6 months, but he already had teeth by 4 and a half months, so quite a bit earlier than my firstborn.

So far he’s mostly just had fruits and veggies (minus the more acidic ones like strawberries, tomatoes, pineapple, etc.) and beans. He’s getting his molars now, so we’ve tried a few grains (no gluten yet) and a tiny bit of meat. We’ll still wait a while for dairy, gluten, and nuts. We make additions slowly so that we can watch for reactions, and if he does show any signs of sensitivity we stop the new food and try it again after a month or two. By this age, my first born had started wheezing. We’ll have to wait and see if my second baby develops asthma or any other respiratory issues, but so far, so good.

Ultimately, I don’t know if this different approach to feeding will make a big difference for my second child’s health. He also has a different set of genes to work with. But I have more information now, along with my personal experience with my first child, and I’m trying something different.

I share my own experience not because the research and statistics on method of delivery and childhood health doesn’t matter; I believe it does. I just share it because the development of these health issues is so multifaceted, and statistics are just that, statistics. Nothing we do can guarantee perfect physical, psychological, or spiritual health in our children. We just do the best we can with the knowledge we’ve gathered, the choices we’ve made, and the circumstances we’ve been given.  

I’m not totally sold on any one way of infant food introduction. I’d love to hear  your own experience of how you introduced food to your baby and if they have any food allergies, asthma, etc. Tell me about it in the comments!

Dear Expectant Mama: What You Should Know About the Benefits of Vaginal Birth

I am not a medical professional. Please research your options and discuss them with your care provider when making health decisions. This post may contain affiliate links. This means that if you make a purchase, I may make a small commission at no additional cost to you. Thank you for supporting this free resource! See full disclosure here.

Dear Expectant Mama,

You might be wondering what the big deal is about having a c-section versus having a vaginal birth. Perhaps you’ve seen news articles, health organizations, or advocacy groups calling for lowering the cesarean rate, which is currently just over 30% in the US and globally is steadily climbing. Cesarean birth is so common now that on the one hand its relative safety and ready availability in an emergency is often taken for granted, and on the other hand its risks are often minimized. Some women are so fearful of vaginal birth that a cesarean seems like a desirable alternative.

So what ARE the benefits of a vaginal birth?

 

[Please note that in this post many of these benefits of vaginal birth are set in the context of risks of a cesarean birth, since cesarean birth is the other possibility. This is never meant as a criticism to mothers who have experienced cesarean birth, whether by choice or necessity.]

1 – A quicker, easier recovery for the mother.

Healing after birth is a big job for your body to complete, and so is caring for a brand new baby! Postpartum and adjusting to mothering a little human is challenging, and those few months following birth are especially significant to a mother and baby’s well-being. The better a mom is feeling physically, the easier it will be to focus on bonding, getting a good start to breastfeeding, and learning each other’s rhythms and patterns, which are all so important to your journey as a new mother.

After you give birth there is always healing to do. But if you give birth by cesarean, your body will have to heal the layers of skin and muscle where your incision was made, and, in all likelihood, this will simply take longer than healing vaginal stretching, tearing, or even an episiotomy. There may be pain or infection at the incision site, and there is also the possibility of other organs accidentally being injured during surgery. These circumstances may further prolong healing or require additional medical attention. Whether you give birth vaginally or surgically, the good news is that your body is designed to heal.

2 – A healthier microbiome for the baby.

Every human is colonized with a variety of microbes (mostly bacteria, along with fungi, viruses, protozoa, and archaea) that either helps or hinders the health and function of the body. Before your baby is born, she is for the most part protected from bacteria by the amniotic sac, but once your water breaks, your baby starts being exposed to bacteria from your vagina. Your own microbiome is passed on to her as she is “seeded” with the first bacteria she comes into contact with. As your baby is born and hopefully handed straight to your arms, she comes into contact with more bacteria from your skin. As you nurse your baby she is being fed with the perfect food to feed the right kind of bacteria in her gut, the seat of her immune system.

When a baby is born by cesarean, she doesn’t get the chance to pass through the vagina and be seeded with your bacteria. Instead she first comes into contact with the hospital environment and medical staff, so she is seeded by different bacteria. The method of birth isn’t the only factor to microbiome health, but babies born by cesarean generally have a less diverse microbiome with a less healthy balance of good and bad bacteria.

Higher rates of autoimmune and allergic diseases like asthma, type 1 diabetes, and celiac disease are correlated with cesarean birth, and microbiome health may very well be a contributing factor to these higher rates. It should be noted that correlation does not equal causation. There may perhaps be other factors that lead to an increased risk of both cesarean birth and autoimmune diseases, causing their increases rates to correlate. We simply do not know with certainty the exact factors involved in a child’s development of certain diseases.

If you have a cesarean birth…

At times, having a cesarean is due to factors completely outside your control, or you may have very personal reasons for wanting a cesarean birth. So if you do need or want a c-section, you can talk to your care provider about taking measures to help support a healthy microbiome in your baby. Vaginal swabbing, a procedure in which sponges are placed in your vagina prior to the birth and then are swabbed all over the baby, is a practice that helps to partially restore the microbiome. You may also be able to have immediate skin-to-skin in the operating room, and breastfeeding will also help create a healthier microbiome in your baby.

If you want to learn more about the microbiome…

Check out these resources:

“Your Baby’s Microbiome” by Toni Harman

“Microbirth” a documentary based on the book

microbirth.com, the corresponding website. They frequently offer a free webinar, “Understanding the Infant Microbiome”

3 – Better respiratory health for the baby.

As your baby passes through the birth canal, the pressure squeezes amniotic fluid from the lungs. As already mentioned, your baby’s microbiome may play an important part in her risk of developing asthma, but this process of squeezing during birth along with exposure to hormones during labor are also thought to play an important part in respiratory health, as they ready the lungs for breathing.

Some studies have shown that vaginally born babies have a decreased risk of transient tachypnea, which is abnormally fast breathing during the first few days of life. If a baby is born by cesarean before 39 weeks and without proof of adequate lung maturity, she has an increased risk of respiratory distress syndrome. Vaginally born babies are also less likely to be admitted to the NICU, but this could be due to factors that make both cesarean and NICU care more likely.  So if a baby has a known health concern that makes cesarean birth safer, that health concern may also mean the baby is more likely to need NICU care.

Here is my own experience with having a child with respiratory issues.

4 – Safer future pregnancies.

Perhaps you’ve heard “once a cesarean, always a cesarean”. The reality is in many cases if you’ve had a cesarean, a VBAC (vaginal birth after cesarean) may be a totally legitimate option for you, but finding a care provider who is truly supportive (and not just tolerant, or worse, actually opposed to VBAC) can be a challenge! On the other hand, depending on your individual circumstances a repeat cesarean may be the only safe option for you, or you may look at the risks and benefits of both VBAC and repeat cesarean and decide you are more comfortable with those of a repeat cesarean.

If you have a cesarean and still want more children you might want to think more seriously about trying for a VBAC (chances are you’ll be successful). Complications like placenta previa or placenta accreta that are more common after a cesarean also increase with each additional c-section, while the risk of uterine rupture, which is an increased risk during a VBAC, decreases with each additional VBAC. Both VBAC and repeat cesarean carry more risk than a second vaginal birth, and some studies have shown an increased risk of stillbirth after a cesarean while other studies have shown the increase to be only very slight. So if you can avoid a primary cesarean your future pregnancies simply carry fewer risks.

 

Cesarean and VBAC Resources:

ICAN International Cesarean Awareness Network

The VBAC Education Project This is a resource offered by ICAN. It contains a wealth of information about your options for subsequent births after a cesarean.

VBACfacts.com An organization dedicated to sharing evidence-based information on  VBAC and making VBAC more accesible

“The VBAC Companion” by Diana Korte

“10 Steps to Finding a VBAC Supportive Provider” by ImprovingBirth.com

5 – Less risk to future fertility.

While secondary infertility can happen to anyone, some studies have shown that having a c-section may place you at higher risk of future infertility, and unplanned hysterectomy, and adhesions that may cause long-term pelvic pain are also increased risks for women who have had c-sections.

If you’re a cesarean mama struggling to conceive or struggling with pelvic pain, I highly recommend exploring NaPro technology to try to help address your concerns. NaPro used specialized surgery and works with a woman’s cycle to try to get to the root cause of a problem and is less invasive than many traditional fertility treatments. I wish I had known about it when I was struggling with infertility!

6- Easier breastfeeding and bonding.

For years the norm has been to whisk baby away to be cleaned, weighed, and monitored after a c-section. In fact, for many years that was even the norm after a vaginal birth. Many hospitals are now encouraging more “baby-friendlypractices, and unless there is some complication you can usually hold and breastfeed your baby immediately after a vaginal birth.

Oxytocin produced during labor makes you and your baby ready to bond, so even if your labor ends in a cesarean, being in labor beforehand still provides you and your baby with some of the benefits of labor hormones. If you have skin-to-skin immediately or quickly after birth, yourbaby can start smelling and exploring and may even latch on by herself. 

After a vaginal birth you’re more able to sit in a more upright position that makes it easier to hold the baby, and your baby won’t be pressing against an incision while she’s nursing. There’s more to bonding than hormones and immediate skin-to-skin, and you absolutely can breastfeed after a c-section, but it may take more work and perseverance from you.

Gentle Cesarean

If you do need a cesarean, talk to your care provider (preferably during pregnancy) about gentle cesarean options. While it’s certainly not mainstream yet, many care providers are willing to support your wishes to have quick skin-to-skin and initiate breastfeeding without delay and without separating you and the baby while you’re in recovery. Because of the strong medications needed during a cesarean, you’ll need your partner, a doula, or a nurse to help you hold the baby securely, and you may feel too sick to hold the baby right away, but as long as you’re feeling up to it, you don’t have to miss out on those early moments of bonding immediately after birth. Whether you’re planning a cesarean or just want to be prepared in the case that a cesarean becomes necessary, you do need to make sure your care provider is supportive of this plan before your baby arrives!

References:

de la Cruz, C., Thompson, E., O’Rourke, K., & Nembhard, W. (2015). Cesarean section and the risk of emergency peripartum hysterectomy in high-income countries: A systematic review. Archives of Gynecology and Obstetrics, 292(6), 1201-15;

Donovan S, M, Comstock S, S, Human Milk Oligosaccharides Influence Neonatal Mucosal and Systemic Immunity. Ann Nutr Metab 2016;69(suppl2):41-51

I. Gurol-Urganci, S. Bou-Antoun, C.P. Lim, D.A. Cromwell, T.A. Mahmood, A. Templeton, J.H. van der Meulen; Impact of Caesarean section on subsequent fertility: a systematic review and meta-analysis, Human Reproduction, Volume 28, Issue 7, 1 July 2013, Pages 1943–1952

Keag, Oonagh E., Jane E. Norman, and Sarah J. Stock. “Long-Term Risks and Benefits Associated with Cesarean Delivery for Mother, Baby, and Subsequent Pregnancies: Systematic Review and Meta-Analysis.” Ed. Jenny E. Myers. PLoS Medicine 15.1 (2018): e1002494. PMC. Web. 18 May 2018.

Magnus, Maria C. et al. “Delivery by Cesarean Section and Early Childhood Respiratory Symptoms and Disorders: The Norwegian Mother and Child Cohort Study.” American Journal of Epidemiology 174.11 (2011): 1275–1285. PMC. Web. 17 May 2018.

Metz, Torri D. et al. “Simple, Validated Vaginal Birth After Cesarean Delivery Prediction Model for Use at the Time of Admission.” Obstetrics and gynecology 122.3 (2013): 571–578. PMC. Web. 17 May 2018.

Neu, Josef, and Jona Rushing. “Cesarean versus Vaginal Delivery: Long Term Infant Outcomes and the Hygiene Hypothesis.” Clinics in perinatology 38.2 (2011): 321–331. PMC. Web. 21 May 2018.

Prior E1, Santhakumaran S, Gale C, Philipps LH, Modi N, Hyde MJ. (2012). Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. The American Journal of Clinical Nutrition, Volume 95, Issue 5, 1 May 2012, 1113–1135.

Rossi, A., Lee, R., & Chmait, R. (2010). Emergency Postpartum Hysterectomy for Uncontrolled Postpartum Bleeding: A Systematic Review. Obstetrics & Gynecology, 115(3), 1453-1454.

Van der Woude, D.A., Pijnenborg, J.M., & de Vries, J. (2015). Health status and quality of life in postpartum women: A systematic review of associated factors. European Journal of Obstetrics & Gynecology and Reproductive Biology, 185, 45-52.